Expanding Learning Presence to Account for the Direction of Regulative Intent: Self-, Co- and Shared Regulation in Online Learning Suzanne Hayes Empire State College, State University of New York Sedef Uzuner Smith Lamar University Peter Shea University at Albany, State University of New York Abstract As the pivotal role of self-regulation has been widely accepted in online learning literature, much interest is focused on identifying pedagogical strategies to help foster regulatory behaviors in online learners. The authors of this article argue that the learning presence (LP) construct, a recently proposed addition to the Community of Inquiry (CoI) theoretical framework of online learning, needs to be included in these conversations. To this end, they re-articulate and clarify the underlying structure of LP by drawing on the theoretical models of self-regulation, co-regulation, and socially shared regulation. They further present examples to illustrate how LP can manifest itself in learners’ discourse in the online learning environment. Finally, they conclude by outlining strategies online instructors can use to help learners execute regulatory behaviors and thus demonstrate LP in online courses. Online Learning Volume 19 Issue 3 (2015) <<15>> Introduction There is a growing body of literature that employs the Community of Inquiry (CoI) framework— developed by Garrison, Anderson, and Archer (2000)—to investigate and explain the effectiveness of online teaching and learning (see Arbaugh, 2008; Benbunan-Fich & Hiltz, 2003; Boston et al. 2009; DiRienzo & Gregory, 2014; Kang & Im, 2013; Stodel, Thompson, MacDonald, 2006). This framework asserts that successful online learning occurs through the cultivation of three forms of presence: social presence, teaching presence, and cognitive presence. Social presence refers to behaviors that enhance rapport, trust, and collegiality among online course participants; teaching presence refers to the design and facilitation of learning tasks and their assessment; and cognitive presence refers to shared negotiation of meaning through knowledge construction. As Swan and Ice (2010) stated, “Since its formulation, the CoI framework has been adopted and adapted by educators worldwide. It has been used in a variety of ways to inform both research and practice in online and blended learning” (p. 1). Recently, we highlighted the CoI framework’s lack of attention to the attitudes and behaviors that engaged and active students bring to their individual and collaborative online activities (Shea et al., 2012, 2013, 2014). Specifically, we described prior research efforts to examine evidence of teaching, social, and cognitive presence within all areas of an online course which resulted in examples of learner discourse that could not be reliably coded as the three key CoI indicators (Shea, Hayes & Vickers, 2010). Further investigation suggested to us that learners’ discourse focusing on individual and group efforts to regulate their learning (such as understanding instructions provided by the instructor, dividing up tasks, managing time and setting group project goals, etc.) could not be accounted for by the existing constructs found within the CoI framework. To account for these missing behaviors, we called for inclusion of a new presence into the framework, called learning presence (LP). We defined LP “by the phases of forethought, performance, and reflection associated with self-regulated learning, but with emphasis on the goals and activities of online learners specifically” (p. 10). We further proposed that the LP construct is “simultaneously self- and co-regulatory in nature as it is predicated on not only individual efforts, but also group dynamics within collaborative learning activities” (p. 10). Given that exploration and discussion of the LP construct is in its early stages (see e.g., Akyol & Garrison, 2011; Garrison & Akyol, 2013; Hayes, 2014; Mayordomo & Onrubia (In press); Traver, Colchok, Bidjerano & Shea, 2014; Wertz, 2014), we propose further clarification of its underlying structure is needed. In our earlier studies described above we suggested the LP construct was “simultaneously self- and co-regulatory in nature.” This statement, while accurate, requires further elaboration. In this paper, we will explicate and exemplify the self- and co-regulatory processes the LP construct encompasses by drawing on salient differences among self-regulation, co-regulation, and socially shared regulation identified by Volet, Vauras, and Salonen (2009), Hadwin, Järvelä, and Miller (2011), Hadwin and Oshige (2011), and Grau and Whitebread (2012). Learning Presence Construct Viewed through Self-Regulation, Co-Regulation, and Shared Regulation The notion of self-regulation in education literature is generally based on Zimmerman’s (1989, 1990, 2008) three-phase model of the cyclical processes of planning (forethought), performance (monitoring and strategy use), and evaluation (reflection). In this model, self-regulation is described as “proactive processes that students use to acquire academic skill, such as setting goals, selecting and deploying strategies, and self-monitoring one’s effectiveness” (Zimmerman, 2008, p. 166). The self-prefix in self-regulation indicates the learner is concerned with regulating his/her own thinking, motivation and behavior during learning. Against this theoretical backdrop, Grau and Whitebread (2012) refer to self- regulation as “intra-personal regulation” (p. 401). Additionally, the emphasis on the word ‘proactive’ in Online Learning Volume 19 Issue 3 (2015) <<16>> Zimmerman’s formulation indicates self-regulation is a product of deliberate action. This idea is reinforced in Hadwin, Järvelä, and Miller’s (2011) definition of self-regulation when they wrote, “Self- regulation of learning refers to a learner’s deliberate planning, monitoring, and regulating of cognitive, behavioral, and motivational/emotional processes towards completion of an academic task/goal” (p. 68). In our work, Zimmerman’s (1989, 1990, 2008) three-phase model of the cyclical processes of planning (forethought), performance (monitoring and strategy use), and evaluation (reflection) also formed the theoretical background for the LP construct to represent the regulatory activities of online learners. However, in our description of the LP construct, we conflated the intrapersonal (regulating self) and interpersonal (regulating others) dimensions rather than separating them. As Iiskala, Vauras, Lehtinen, and Salonen (2011) wrote, intrapersonal regulation is not equivalent to interpersonal regulation, and vice versa, therefore, both types of regulation “should be conceptualized differently” (p. 379). In line with this reasoning, we define the self-regulation aspect of LP as “Regulation behavior used by the [learner] mainly to regulate himself/herself, with no apparent intentions to influence other [learners’] cognitions, emotions and behaviors” (Grau & Whitebread, 2012, p. 411). Next, we also delineate the interpersonal (social) aspects of LP. In the literature on student regulation of learning, the interpersonal dimension of regulation is referred to as co-regulation (Salonen, Vauras, & Efklides, 2005; Volet, Summers, & Thurman, 2009). Co- regulation means regulation directed toward a specific member of a group in a collective activity, and it stands in contrast to self-regulation where regulation is directed toward one’s own individual performance. To convey the meaning of co-regulation, Grau and Whitebread (2012) use the following examples: • Peer tutoring in which one [learner] monitors or controls another [learner] who might need some help with some aspects of the task • When a [learner] is trying to influence another [learner’s] behavior either because the second is not doing well in the task or is not behaving properly in order to carry out the activity. To expand Grau and Whitebread’s definition a bit farther, we can apply Hadwin, Järvelä, and Miller’s (2011) idea that co-regulation is “a manifestation of emergent interaction within [Vygotksy’s] . . . zone of proximal development” (p. 73). It is this expanded notion of co-regulation that we draw on here to explicate the co-regulatory dimension of the LP construct. As such, the co-regulatory aspect of LP refers to asymmetrical situations whereby one member of a group with more knowledge and skills provides scaffolding support for another. Shared regulation is another term used in the literature to account for the social aspects in the regulation of learning (Iiskala, Vauras, & Lehtinen, 2004; Vauras, Iiskala, Kajamies, Kinnunen, & Lehtinen, 2003). Unlike co-regulation, which includes asymmetrical scaffolding, shared regulation refers to “a symmetrical style of communication” wherein regulation is directed toward “some shared understanding or strategic decision within the group” (Grau & Whitebread, 2012, p.5). According to Volet, Vauras, and Salonen (2009), shared regulation “is considered the most profoundly social mode of regulation, because it refers to individuals’ metacognitive processes that operate as a genuine social entity, aimed at a single direction, that is, the fully shared goal for the activity” (p. 219). Put another way, Hadwin and Oshige (2011) state shared regulation refers to those “processes by which multiple others regulate their collective activity.” This collective regulation reflects “shared awareness of goals, progress, and tasks toward co-constructed regulatory processes” (p. 254-255). In light of these descriptions, we argue the interpersonal dimension of regulation encompassed by the LP construct is shared regulation, which refers to symmetrical situations where members of a group collectively set goals, track their progress, use strategies, and consider their effectiveness in the service of a shared outcome. Online Learning Volume 19 Issue 3 (2015) <<17>> In sum, the above-mentioned differences among self-regulation, co-regulation, and shared regulation have led us to conclude that the LP construct includes the three-phase model of the cyclical processes (planning, monitoring, and reflection) at three levels: an individual looking after his/her own activity (self-regulation); an individual scaffolding and regulating another’s learning (co-regulation); and individuals working together to regulate each other’s learning (shared regulation). Below we will demonstrate each regulation type within the LP construct with examples found in the discourse of online learners. The examples will show how LP can manifest itself in learners’ discourse in the online learning environment. Examples of LP Showing Direction of Intentionality: Self-, Co-, and Shared Regulation Before we illustrate the three dimensions of the LP construct with examples, we must describe the context from which we selected those examples as well as the methodology we used for their identification and analysis. Context The course, Advanced Health Assessment, which was offered in a school of nursing at a college in the northeast, provided the setting. It was delivered via Moodlerooms during the 2013 fall term. Eighteen students were enrolled in the course. Before the class was divided into four teams for a six- week-long collaborative project, we obtained consent from nine of the students (constituting two teams) to access, read, analyze and use anonymized quotes from their project related conversations. The project required teams to develop a plan of care for an assigned case, using a wiki as their authoring tool for the final product. Both teams were provided with identical project instructions. They were also provided identical workspaces within the Moodlerooms to support their planning and decision-making. These workspaces were a discussion area for asynchronous communications and an optional chat area for real time conversations. The LP examples we provide here come from these discussions and chats. Methodology We began our search for examples for this article by creating a chronological transcript of the two teams’ discussions and chats, and by replacing all names with pseudonyms. The transcripts yielded a total of 435 messages. To ensure systematic selection of examples from these messages, we decided to first count frequencies of LP in them and then qualitatively examine the regulative direction in segments of those messages. For our first task, we employed quantitative content analysis, which is often used in studies of computer-mediated communications and learning (e.g., DeWever, Schellens, Valcke, & Vankeer, 2006; Gunawardena, Lowe & Anderson, 1997; Henri, 1992; Rourke, Anderson, Garrison & Archer, 2001) to create categorizations and frequency counts based on a pre-established or emergent coding scheme. Using the LP coding scheme (Shea et al. 2012; Shea et al., 2013; Shea et al., 2014) with some modifications (see Appendix), we identified occurrences of LP in both teams’ transcripts. To calibrate consistency in applying the LP codes, two of us first practiced coding using two archived team discussions from an earlier term of the same course (we call this phase ‘practice coding’). Because the LP construct addresses the regulatory processes students display, instructor postings were excluded from our analysis. After calibration, we shifted our attention to the discussion and chat postings generated by the nine students who comprised the two teams identified above (we call this phase ‘actual coding’). During the practice coding and the actual coding, we first worked independently to examine each sentence in every posting to identify one of the four LP categories (forethought and planning, monitoring, strategy use, and reflection). Online Learning Volume 19 Issue 3 (2015) <<18>> Following this, we met to negotiate our disagreements. We used Holsti’s coefficient of reliability to calculate inter-rater reliability (IRR). Neuendorf (2002) considers an IRR of .70 to be reliable. In both the practice and actual coding, we obtained an IRR that exceeded .70 initially and reached 100% agreement during negotiation of disagreements (see Table 1). Table 1 Inter-rater Reliability for LP Coding: Holsti’s Coefficient of Reliability Initial Negotiated (CR) (CR) Practice Coding 1 0.81 1.00 Practice Coding 2 0.88 1.00 Actual Coding Transcript 1 0.77 1.00 Actual Coding Transcript 2 0.79 1.00 The aggregated findings for the two teams yielded a total of 396 LP indicators which were distributed as follows: Table 2 Frequency of LP Indicators Forethought & Monitoring Strategy Use Reflection Total Planning Count % Count % Count % Count % Count % 116 29.2 183 46.2 90 22.7 4 1.9 393 100 For our second task of qualitatively examining the regulative direction in segments that were identified as LP in the transcripts, we employed directed qualitative content analysis. This is a structured approach where textual content is coded into categories based on an existing theoretical framework or theory (Hsieh & Shannon, 2005). During this analysis, we applied the three categories of regulation listed below, which were derived from our preceding review, to the LP coded messages. • Self-regulation when the utterances included “behavior used by the [learner] mainly to regulate himself/herself, with no apparent intentions to influence other [learners’] cognitions, emotions and behaviors” (Grau & Whitebread, 2012, p. 411). • Co-regulation when the utterances included asymmetrical situations whereby one member of a group who has more knowledge and skills provides scaffolding support for another • Shared regulation when the utterances included symmetrical situations where members of a group collectively set goals, track their progress, use strategies, and consider their effectiveness in the service of a shared outcome. So far, we have described the systematic efforts we made to select the examples to show how LP can manifest itself in learners’ discourse in the online learning environment. Below, we present the examples. Self-Regulation Dimension of LP In our discussion above, we argued the LP construct encompasses students’ regulatory activities at three levels, one of which is self-regulation, referring to an individual looking after his/her own activity. In the transcripts we observed numerous instances in which students verbalized their self- regulation processes. For example, in Figure 1, a student, Crystal, identifies a problem (lines 1-2), which is uploading a file to the team’s wiki, and then acts to resolve this problem on her own (lines 4-5) by contacting the help desk. Crystal’s use and verbalization of self-monitoring and help seeking strategies are examples of the self-regulatory aspect of the LP construct: She identifies a problem and takes Online Learning Volume 19 Issue 3 (2015) <<19>> intentional productive action to advance her performance. It is this sense of student-initiated intentional productive action in online learning that the LP construct accounts for with its self-regulation component. Line Student Posting LP Code 1 Crystal: I just want you all to know that I am having a problem MO2 Identifying problem 2 with the wiki site. When I click on the files tab, I do not have 3 the icon on the bottom that says “Edit wiki files.” Therefore I Seeking, offering or 4 cannot add a file. I was on the phone today with tech support SU1 providing guidance 5 and they were unable to resolve my problem. They will notify 6 me by email as soon as it is corrected. 7 Figure 1. Excerpt from asynchronous discussion illustrating self-regulation. In the next example (see Figure 2) the first student, Sarah, raises a series of questions related to how and where the team should present their individual contributions for their care plan. Rather than answering these questions directly, a second student, Fern, demonstrates metacognitive awareness and surfaces her own concerns about the work she has just recently completed. In doing so, Fern describes a series of self- initiated acts of self-regulation: her awareness of her own learning behaviors in terms of recognizing her strengths and weaknesses (lines 8-9); her recognition of the need for better formatting as an area for improvement (lines 11-12); and asking for assistance to accomplish this (lines 13-15). It is notable that Fern not only identified these specific concerns independently, but that she was also able to verbalize them to her peer, Sarah. Again, as is the case in the previous excerpt, Fern’s verbalization of her self- regulatory activities points to the conscious deliberate actions she has undertaken to assume responsibility for her learning. This awareness of personal conditions (e.g., cognitive states, abilities, and actions) and seeking ways to improve those conditions is a critical component of the self-regulation aspect of LP. Line Student Postings LP Code 1 Sarah: Hi all, I was just thinking that it might be helpful to present 2 the care plans and information on each of our selected CHF 3 (congestive heart failure) topics as it would be presented in an 4 educational pamphlet. When creating the final project, this would 5 make it easier to put all the pieces together. Also, I was wondering if 6 we should create the pamphlet in a Word program or use the Wiki 7 project place? 8 Fern: Hi all, Computer formats and templates are not my strong MO6 Recognizing 9 area. Please review the wiki for the template… learning behavior(s) in self /others 10 I entered by information part of the care plan with MO4 Evaluating 11 interventions/prevention, goals for Libby. It needs to be formatted quality 12 better, for easier reading for the patient. 13 I need help with the format to make sure that all information fits on SU1 Seeking, 14 the page. There is [sic] five columns, too many [and the] font [is] too offering or 15 small for the patient to read. Help please. providing guidance 16 Please advise if I left anything out or need to add more information. 17 Thank you for your help. Figure 2. Excerpt from asynchronous discussion illustrating self-regulation. Online Learning Volume 19 Issue 3 (2015) <<20>> Co-Regulation Dimension of LP A second level of regulatory activity the LP construct encompasses is co-regulation. Co- regulation is evident when one learner provides scaffolding and support to another. Displayed in the student-student exchange in Figure 3, Samantha provides scaffolding to Pat to help her accomplish the given task by shifting Pat’s view of a potential problem into an unrecognized opportunity. The excerpt begins with Pat indicating she has limited access to health care professionals who would be suitable to interview for the case study. Pat identifies this potential barrier to her participation in the team’s project and conveys it to her team members (lines 5-9). In response, Samantha offers guidance, a form of intentional strategy use, to help Pat realize she does in fact have access to a professional who is suited to the requirements of the case study (lines 15-17). In the process of this interaction, we see the following aspects of co-regulation that the LP construct encompasses: One student exhibits misunderstandings or gaps in knowledge that prevents him/her from successfully completing a task; and another student takes the opportunity to remediate those misunderstandings or knowledge gaps through interactions that can be characterized as “I see something that you don’t see, and I can help.” Line Student Postings LP Code 1 Pat: Hi, I was again reading the directions tonight and I have come to MO2 Identifying 2 the same conclusion that we first have to do an interview with problems 3 another profession. My question is: are we going to be given a new 4 case study or are we going with the previous one "Manny"? I work 5 in home care, so I have access to Medical Social Workers, and 6 Registered Dietitians, the only issue I see is that most of the clientele 7 that these professions deal with are seniors. [the project is about an 8 overweight youth with asthma] 9 10 SU1 Seeking, Samantha: I had the same question as to if we are getting a more 11 offering or detailed case study. I can interview a dietician, as she actually 12 providing specializes in peds [pediatric] patients. (assuming the patient is still 13 guidance obese) -- I already spoke to one on my floor about the possibility of 14 an interview. Although if he isn’t obese then she won’t be able to 15 contribute much. Pat, what about interviewing a social worker? 16 They usually deal with all types of patients and families. 17 Figure 3. Excerpt from synchronous chat illustrating co-regulation. The interactions featured in the next excerpt (Figure 4) illustrate another instance where Samantha offers technical help (about wiki use) to another student, Crystal. In this series of exchanges, it is notable that Samantha offers procedural help and guidance to check or confirm Crystal’s understanding (lines, 1-2, 4, 7, 11-14). Crystal, in turn, uses self-monitoring to identify where she encountered problems (line 3) and conveys her willingness to remain engaged by “trying again” (lines 9-10). Ultimately this interaction marked by Samantha’s co-regulative actions served as a valuable investment of effort because Crystal was then able to work independently in the wiki for the duration of the project. Online Learning Volume 19 Issue 3 (2015) <<21>> Line Student Postings LP Code 1 Samantha: Do you want to go to the wiki page now and we can have SU1 Seeking, 2 you add something in? offering or providing guidance 3 Crystal: I just tried to add the [text for the] cover page and couldn't do MO2 Identifying it problems 4 Samantha: Hmmm. Are you copying and pasting it in? MO1 Checking or confirming 5 Crystal: I think Pat put the pictures of the different HCP [health care MO2 Identifying a 6 providers] in the files Problem 7 Samantha: You can't add the whole file separately… SU1 Seeking, offering or providing guidance 8 Samantha: I've been using copy/paste [in the wiki’s editor.] SU1 Seeking, offering or providing guidance 9 Crystal: I will try again. I did add [information that the family] add that MO5 Appraising 10 all speak and understand English. personal engagement 11 Samantha: Okay... good. We can write directly in the document… SU1 Seeking, 12 Where you see the FILES tab, there is also an EDIT tab... and you can offering or 13 highlight your Word document, copy it and then paste.... I did that with providing 14 mine in the different sections. guidance Figure 4. Excerpt from synchronous chat illustrating co-regulation. The co-regulation aspect of LP, as evidenced in Figures 3 and 4, points to asymmetric, scaffolding-like situations constructed between two students: a student who has familiarity or better understanding of a task/concept assists another student who needs help. It is this collaborative, peer-to- peer scaffolding in online learning that the LP construct accounts for with its co-regulation component. Shared Regulation Dimension of LP In addition to self- and co-regulation, another level of regulatory activity the LP construct encompasses is shared regulation. In the following examples, we demonstrate online students’ collective regulatory intents which are directed toward accomplishing a communal goal. The first illustrates how students undertake purposeful regulative actions to realign their group’s direction after receiving feedback from their instructor. In the second, the members of another team makes a series of regulative decisions as they work on a plan for completing their assignment. Online Learning Volume 19 Issue 3 (2015) <<22>> The dialogue featured in Figure 5 takes place during a scheduled team chat at the mid-point of the project. In this dialogue, the team is about to face an important decision. Earlier in the day, the instructor posted an announcement informing the team they had misconstrued the nature of the written assignment they were to complete (i.e., rather than developing a creative inter-disciplinary plan of care emphasizing health promotion, students created a research paper). In order to refocus the team’s efforts to meet the instructor’s expectations, one of the team members, Fern, notifies the team of the instructor’s feedback by cutting and pasting the text of the instructor’s announcement directly into the chat (lines 1-2). She purposely shares this information to highlight the need for the team to make an adjustment in their strategy to meet the instructor’s creativity requirement (lines 6-9, 12-13). In response, the team members propose alternative suggestions, using the pronoun ‘we.’ The use of this pronoun indicates the team members’ creation of a group perspective rather than an individual one. After exhausting possibilities, the team collectively agrees on a strategy to follow. Line Student Postings LP Code 1 Fern: I just copied and pasted professor’s announcement [above], SU2 Reviewing 2 for us to review. 3 Fern: professor just posted this at 12:22 P.M. today 4 Denise: thank you for re-posting, I haven’t seen this. Now I’m a MO5 Appraising 5 little confused as well on what we're exactly supposed to do. personal reaction 6 Fern: I guess this changes things a bit, So it looks like forget the SU4 Making 7 APA format[ed paper], and we each need to do a care plan based adjustment in 8 on the professional we interviewed based on Libby [our assigned strategy 9 case study]. Thoughts?? 10 Denise: are we setting up the care plan like a diagram though? Or MO1 Checking or 11 just a regular care plan? confirming 12 Fern: The diagram was a creative way to present data for plan. We MO2 Identifying 13 need to decide on creative presentation problem 14 Denise: any ideas on that? 15 Sarah: I’m not sure how to create a diagram MO2 Identifying problem 16 Molly: Just an idea but maybe an illustration of the body showing SU1 Seeking, offering 17 symptoms or providing guidance 18 Denise: what if we made a concept map? SU1 Seeking, offering or providing guidance 19 Molly: Then using ADPIE [Assess, Diagnose, Plan, Identify SU1 Seeking, offering 20 outcomes, and Evaluate] maybe give a nursing dx [diagnosis] and or providing 21 the plan to care for dx [diagnosis], etc. Basically a care plan. guidance 22 23 Fern: Me either, maybe we can do educational handout pamphlet? SU1 Seeking, offering Online Learning Volume 19 Issue 3 (2015) <<23>> 24 Concept map sounds good too, but I do not know how to format or providing help 25 boxes to input data, It may be hard to visualize, if we do we may MO2 Identifying 26 need to do several concept maps for each professional we problem 27 interviewed for case study. 28 Denise: I’m okay with whatever everyone else is. I like the idea of 29 a pamphlet. 30 Molly: Yes, a pamphlet is a good idea. 31 Sarah: I agree on the pamphlet. Figure 5. Excerpt from synchronous chat illustrating shared regulation. Note: Not all applicable LP codes are shown in this example. The shared regulation aspect of the LP construct is also evident in Figure 6 which highlights a conversation that took place as one team worked toward establishing a shared plan for how to approach the assignment. As seen in the previous example, this team also uses inclusive pronouns such as “we” and “ours,” indicating a clear direction for their regulatory intent. Here, shared regulation commences with students using collective forethought and planning as they consider how they will coordinate their activities and assign specific tasks to each other to complete the assignment (lines 6-24). This team also uses monitoring as they acknowledge problems and check for mutual understanding (lines 33-39). Lastly, the team moves toward a better shared understanding of their assignment (lines 40-52) as a result of one team member effectively demonstrating the value of using a specific regulatory strategy: reviewing course content (i.e., instructions) when beginning an assignment. Line Student Postings LP Code 1 Samantha: Hi Team! We are now in module 6 and we are asked to 2 conduct interviews presenting our case study. 3 If you go back to module 2, our case study is there. SU2 Reviewing 4 Let's discuss who each person in the group would like to interview. FP1 Goal setting 5 6 I'd like to interview a registered dietitian who specialized in pediatrics. FP3 Assigning task 7 I work in the neonatal ICU, but she comes in everyday to assess our to self 8 babies’ diets and caloric intake. Our patient "Manny" is 4 feet 6inches 9 and 112 pounds, which makes him obese. I think interviewing the SU3 Noting 10 dietitian will help us deal with his obesity as well as ways to address outcome 11 Manny's mother who seems to think Manny is just a "healthy growing expectations 12 boy" (according to the case study quiz we initially took). 13 14 I just saw that people were responding who to interview for this part of 15 the project in last week’s module. Is anyone able to interview a FP3 Coordinating respiratory therapist? I have access to one who does NICU/Pediatrics tasks 16 if no one else does... 17 18 Pat: Hey, on Monday I wrote and now it’s gone? I asked the same MO2 Noting 19 question: problem 20 Samantha: Dietician 21 Pat: Medical social worker Online Learning Volume 19 Issue 3 (2015) <<24>>